Registrar's Message

Brian O'Riordan

Registrar

Brian O’Riordan
Registrar

We recognize that registering with a regulatory body is an added cost to working as an Audiologist and/or Speech-Language Pathologist and so we work diligently to be fiscally responsible with the money generated by your Membership fees.

Colleges do not receive any government funding and so must be funded entirely through College application and registration fees.

All Colleges, regardless of the number of registrants (e.g. 600 Chiropodists or 150,000 nurses, or 4,000 audiologists and speech-language pathologists) must be able to register individuals initially, approve their licensing each year following quality assurance assessments, and address any complaints. In order to do this, College Councils must ensure that they have the regulations, by-laws, practice standards, and processes in place to be able to assure the public that they are receiving care from qualified practitioners.

In CASLPO’s case, we regulate two professions. So, there is added complexity to our work which ultimately impacts resources and costs.

For self-regulation to work, registrants must be made aware on an ongoing basis of what is expected of them regarding regulations, practice standards and codes of conduct.

This is why the College provides to members:

practice advice;

webinars;

group e-mails;

newsletters;

videos and brochures;

user-friendly website;

membership forums and e-Forums

The College also ensures that in complaint situations, members are informed of their rights and are treated fairly throughout the investigative processes. The College must be objective and fair in all its interactions with registrants and with members of the public.

Recently, the Minister of Health and Long-Term Care, patient advocacy groups and the media have been strongly challenging Colleges to be more transparent and accountable about their work and to enhance public awareness about what they do and who they serve. The College’s initiatives outlined in CASLPO’s existing strategic plan and goals support the College’s mandate and the government’s commitment to public transparency and accountability.

Learn how your fees are at work protecting the public interest by reviewing the ‘Your Fees At Work’ infographic in this issue of ex•press.

Council Highlights

Carol Bock

Deputy Registrar

Carol Bock
Deputy Registrar

Here’s what happened at the March 3 and June 9, 2017 Council meetings (click here for meeting materials):

Provincial Initiatives

The newly passed Bill 87 “Protecting Patients Act, 2017” was discussed at Council. This legislation upholds and reinforces zero-tolerance for patient sexual abuse and will allow CASLPO to make by-law changes to support victims of sexual abuse.

The Federation of Regulated Health Professionals of Ontario (FHRCO) launched its Ontario Health Regulator’s website, which serves as a gateway to all 26 Colleges’ websites.Click here to learn more and share the link widely.

Revised Position Statement

National Initiatives

The Canadian Alliance of Audiology and Speech-Language Pathology Regulators (CAASPR) has requested each province to distribute a survey to the members as part of the national competencies validation process. The survey ran from June 27 to July 7, 2017.

Governance

The following Council members were elected to serve on the Executive Committee for the 2017/18 year:

President : Bob Kroll (SLP) District 6

Vice President (Audiology): Véronique Vaillancourt-District 1

Vice President (Speech-Language Pathology): Sandi Singbeil-District 4

Member at Large (AUD): Jennifer Anderson-District 5

Public Member: Ruth Ann Penny

Public Member: Shari Wilson

Finances

Council reviewed feedback from the membership regarding the fee changes. Balancing the feedback with the need for the College to be resourced appropriately, Council made several changes to its original proposals for fee changes. These changes included reducing the proposed 2% fee increase to 1% for the 2017-18 membership year.

Remember, all Council meetings are open to the public, which includes you!

College Updates

Brian O’Riordan
Registrar

Council Elections - 2017 BY-ELECTION

Electoral District 1, Eastern-Ontario

The nomination period for the Council elections in District 1 (Eastern Region) and District 3 (Southwest) closed on July 17 at midnight. As only one eligible nomination was received in District 1, Karen Bright (SLP) has been acclaimed as a new member of the College Council for a three-year term.

Karen graduated with her M.H.Sc. in Speech-Language Pathology from the University of Toronto in 1981 and has worked at Kingston General and Hotel Dieu hospitals (now Kingston Health Sciences Centre) since that time, providing both acute and ambulatory care services to people of all ages with a variety of communication disorders. In 2007, she became the Professional Practice Leader for Allied Health at Hotel Dieu. As part of the role she chaired a tri-hospital inter-professional working group to select and develop the standard documentation methodology for use in the Kingston hospitals and led a hospital wide implementation of the best practice guideline for ambulatory falls prevention as part of the Hotel Dieu Best Practice Spotlight Organization (BPSO) candidacy requirement. For the last ten years, her clinical role has been focused on voice assessment and treatment as a member of the Hotel Dieu/Queen's University Voice Clinic. Effective September 1, 2017, Karen will retire from her permanent position at KHSC and continue on a casual basis. She has completed three terms as a non-Council member of the CASLPO Discipline Committee.

All members in Electoral District 3, Southwest, Ontario received an email on August 2 from the Registrar with a secure link to the online voting portal to vote for one of two candidates.

Voting opened August 2, 2017 and ran until Thursday, September 7, at 12:00pm.

Since proclamation, CASLPO has been working to bring the College into compliance with the legislation through making changes to our By-Laws and policies and providing training to staff and Council members.

Council and staff will be implementing the changes required now and over the coming months. We will communicate about our progress and will look forward to collaborating with members and stakeholders in our work, as well as prioritizing the safety and well-being of all patients in the care of our members.

We support the intent of the legislation and the commitment to addressing and eliminating sexual abuse of patients by members, as well as ways of providing greater transparency regarding College processes. These amendments to the RHPA will offer stronger regulatory tools to address sexual abuse and provide greater public protection overall.

Practice Advice

Samidha Joglekar

Audiology Advisor and Manager of Mentorship

We are pleased to inform you that Samidha Joglekar, audiologist, has joined our team as Audiology Advisor and Manager of Mentorship.

Samidha brings diverse work experiences to her role at CASLPO. For over four years Samidha worked directly with patients and their families at Sunnybrook Health Sciences Centre’s Audiology Services Department, providing hearing and vestibular assessments, prescription and fitting of hearing aids and follow-up care. She also worked in research for three years at the Sunnybrook Research Institute. Her research focus was on examining variability in clinical outcomes for adult cochlear implant patients, including studies of auditory evoked potentials, musical training and perception post cochlear implantation, and the development of a reliable and valid computer based version of the Montreal Cognitive Assessment (MoCA) for the Hearing Impaired. Samidha was also a technical in-house audiologist for a hearing aid manufacturer.

Samidha is your contact person at CASLPO if you are an audiologist requiring practice advice or if you are a speech-language pathologist or audiologist with questions about the College’s mentorship program.

Practice advice is an important service that CASLPO provides to you. You can benefit from one-on-one conversations with our practice advisors regarding legislation, regulations, practice standards and the Code of Ethics and how they apply to different areas of professional practice.

Here are some examples of questions that our practice advisors have helped members with:

1. Question: I am thinking of opening a private practice. What do I need to know about CASLPO standards, guidelines, and regulations before I do so?

Answer: There are several matters to consider when opening a private practice. When working as a sole private practitioner you no longer have the structure of employer’s or owner’s policies and procedures that usually incorporate CASLPO’s regulations and practice standards. You have to ensure that every element of your practice abides by the legislation, regulations and by-laws and follows the College’s Professional Practice Standards. For more information please refer to CASLPO’s practice advice article entitled Opening a Private Practice If you require further guidance or clarification please contact a member of our practice advice team for assistance.

Answer: The Ministry of Health and Long-Term Care prohibits the use of patient testimonials by any regulated healthcare professional in order to protect the public. Consequently, CASLPO’s proposed advertising regulation is clear in its restriction against the use of testimonials. Testimonials, in whatever format, are considered unreliable and unverifiable. There is also a lack of balance as negative comments are rarely included. Finally, one person’s experience will not be the same as another’s, especially with the provision of healthcare. For more information please see our article entitled Advertising-Understanding the Proposed Regulation found in the Practice Advice section of our website.

3. Question: I am looking for a course on cerumen management or taking earmould impressions. Which courses are certified by CASLPO?

Answer: As a regulatory body, CASLPO does not accredit or approve continuing education courses. CASLPO’s mandate is to protect and serve the public interest by regulating the professions.
One way that CASLPO fulfills this mandate is through our Quality Assurance Program, which requires members to evaluate their knowledge, skills, and competency to practice through annual completion of the Self-Assessment Tool (SAT). If there is an area of your practice where you require further education or knowledge you can establish a goal in your SAT and then seek out learning opportunities to gain competence in this area. A learning opportunity could be structured as informal guidance from a more experienced colleague, self-study, or taking a course in-person or online.

4. Question: I am interested in mentoring an initial practice registrant, however, I am confused about my role as a mentor. What is the difference between mentoring and supervision?

Answer: CASLPO’s mentorship program is not intended to be a process of clinical education or supervision. Members who are completing a mentorship for CASLPO purposes are fully registered clinicians who are responsible for their own practice. A central focus of the College’s mentorship program is to provide support and guidance to the clinician being mentored as they learn and apply the practice standards, regulation, and legislation that is significant in Ontario, and outlined in the Self-Assessment Tool (SAT,) to the day-to-day practice of their profession. Experienced members serve as an invaluable resource in this capacity. Mentoring provides the opportunity to connect with a new generation of professionals in our fields and to help shape the next generation to be competent and ethical, making mentorship a vital part of self-regulation.

The Initial Practice Period Guidelines posted in the “Applicants” section of our website is a helpful document for questions about CASLPO’s mentorship program. The roles and responsibilities of mentors, required qualifications of mentors, and the procedures for the mentoring process, are outlined in chapters 2-4 of this document.

In addition to her role as audiology practice advisor Samidha is working closely with our team to implement exciting changes to our mentorship program. Stay tuned for updates in future CASLPO communications!

Registration

Colleen Myrie

Director of Registration Services

RENEW BEFORE THE OCTOBER 1ST DEADLINE

Colleen Myrie
Director of Registration Services

All CASLPO members must renew their registration before midnight on October 1st. Renewal notices were emailed on August 1, 2017. If you did not receive a renewal notice by email, you are still required to complete your renewal by the annual October 1st date.

This year, the renewal deadline will occur on a Sunday. However, on that weekend, assistance will be limited. For the best access to support, we strongly encourage you to complete your renewal as early as possible.

RESIGNING YOUR REGISTRATION

If you wish to resign from CASLPO, you must notify the College by logging into your online renewal profile and requesting a change of status to resigned.

LATE FEES AND OTHER PENALTIES

If you complete your renewal between October 2nd and December 1st at midnight, you will be charged a 20% late fee in addition to the annual renewal fee.

If you have not completed, your renewal by midnight on December 1st, your certificate of registration will be suspended and you will no longer be authorized to practise audiology or speech-language pathology in Ontario. To reinstate your certificate of registration a 50% reinstatement fee is required in addition to the annual renewal fee, so please renew on time.

Quality Assurance

Alexandra Carling Ph.D.

Director of Professional Practice and Quality Assurance

QUALITY ASSURANCE RESEARCH PROJECT

Alexandra Carling, Ph.D.
Director of Professional Practice and Quality Assurance

If you know a member being peer assessed this year or a peer assessor, pat them on the back for the extra work they are doing for the College to help further protect the public.

They are trialling a new component of the peer assessment process, the evaluation of members’ clinical reasoning. The College, under the guidance of the Quality Assurance (QA) Committee, has developed the Clinical Reasoning Tool based on research and measures used by other health regulatory colleges. We want to make sure that it is an effective tool for speech language pathologists and audiologists, and that it is valid and reliable.

The Quality Assurance program has embarked on a research project to measure the effectiveness, validity and reliability of the Clinical Reasoning Tool (CRT)

METHODOLOGY

1) CONTENT VALIDITY

The CRT was sent to university faculty, managers and administrators, members who were recently peer assessed and randomly selected members. Follow up focus groups helped us to determine that the content of the tool was valid.

2) INTER RATER RELIABILITY

The CRT is administered with 2 patient records with each member at the peer assessment site visit. They are audio recorded and securely stored. The peer assessor scores each CRT administration and sends them to CASLPO.

A second peer assessor in the same profession and practice area listens to the audio files, scores the CRTs and sends the forms to CASLPO.
Inter-rater reliability will be measured through statistical analysis.

3) MEMBERS’ PERCEPTIONS OF RELIABILITY AND VALIDITY

Members are sent a short survey to complete and submit before the peer assessment. A five point Likert scale is used to measure responses

Members are sent the same survey to complete and submit after the peer assessment. The members are asked to provide their comments

Pre and post scores and comments will be statistically analysed using quantitative and qualitative measures

4) PEER ASSESSORS PERCEPTIONS OF VALIDITY THROUGH MEASURES OF CONFIDENCE IN DETERMINATION OF CLINICAL REASONING

Following the peer assessment, the peer assessor evaluates their own confidence in determining clinical reasoning using a five point Likert scale. If the peer assessor determines that they are unsure, they are asked to comment. Qualitative and quantitative analyses will be administered.

RESULTS

We are in the process of gathering and analysing all of the data. The results will go to the QA Committee and will be shared with the members being peer assessed and the peer assessors. Based on the results, the QA Committee will revise the CRT and it will be sent to Council for approval.

Stay tuned for the next edition of ex•press where we will summarize the results of the research study.

The Quality Assurance Committee thanks all of the members currently being peer assessed, peer assessors and focus groups. Your hard work and willingness to help the College and its members is much appreciated.

CASLPO Forums

Alexandra Carling, Ph.D.
Director of Professional Practice and Quality Assurance

CASLPO forums help support the College’s mandate to protect the public’s right to quality audiology and speech-language pathology services by providing leadership and education.

WHERE ARE WE GOING THIS YEAR?

We look forward to interactive discussions and, as always, to learn about the issues that are important to our members.

Thank you to the following members for all of their local support including recent Hamilton and Brampton Forums- we couldn't do it without you!

Dianne Parr - Hamilton Wentworth District School Board

Devon Curran - William Osler Health System

Meghan Von Muhlenen/Kelly Favot - Health Sciences North

Laurie-Ann Staniforth - Children's Hospital of Eastern Ontario

From these discussions, combined with the reasons members contact the College through practice Advice, the topics for the e-Forums are established.

E-FORUMS

Complaints and Hearings

Preeya Singh

Director of Professional Conduct

The Obligation to Make Mandatory Reports

Preeya Singh
Director of Professional Conduct

Mandatory reporting does not have to be a daunting task. Many audiologists (AUDs) and speech-language pathologists (SLPs) will likely never find themselves in a position to have to submit a report to a health regulatory College or to the Children’s Aid Society. However, some AUDs and SLPs will become aware of information that could present a serious risk of harm to the public and they are required by the Regulated Health Professions Act, 1991 (RHPA) and the Child and Family Services Act (CFSA) (soon to be the Child, Youth and Family Services Act, 2017) to report this information to the appropriate health College. This requirement is referred to as a “Mandatory Report” and the following are some situations in which a CASLPO member is generally required to make a report:

Sexual abuse of a patient by a regulated health care professional

AUDs and SLPs are required to file a Mandatory Report if they have reasonable grounds, obtained during the course of practising the profession, to believe that another regulated health care professional has sexually abused a patient.

Remember that “sexual abuse” of a patient is currently defined in the RHPA as:

(a) sexual intercourse or other forms of physical sexual relations between the member and the patient,
(b) touching, of a sexual nature, of the patient by the member, or
(c) behaviour or remarks of a sexual nature by the member towards the patient.

Depending on the circumstances, the term “patient” can also include former patients (i.e. individuals who are not currently receiving therapeutic treatment from the regulated health care professional).

Abuse, harm or neglect of a minor

Under the CFSA, if an AUD or SLP has reasonable grounds to suspect that a child has, or is at risk of, suffering mental, emotional or physical harm and the person having charge of the child is responsible or ought to know of the harm, the AUD or SLP is required to make a report to a Children’s Aid Society immediately. (The reporting obligations under the soon to be enacted Child, Youth and Family Services Act, 2017 are essentially the same as those under the CFSA.)

An AUD or SLP is incompetent, incapacitated or has sexually abused a patient

Any party who operates a facility where an AUD or SLP practises has the obligation to file a Mandatory Report if they have reasonable grounds to believe that the AUD or SLP is incompetent, incapacitated, or has sexually abused a patient.

Termination, suspension or imposed restrictions by an employer.

If an employer has terminated, suspended or imposed restrictions respecting the employment of an AUD or SLP for reasons of professional misconduct, incompetence or incapacity, the employer is required to file a Mandatory Report.

Mandatory Reporting is also required if the employer has reasonable grounds to believe that the AUD or SLP has voluntarily resigned, relinquished or restrained their own practice due to concerns of professional misconduct, incompetence, incapacity or in the face of an investigation respecting these concerns.

Dissolution of a partnership, corporation or association with an AUD or SLP.

If an AUD or SLP dissolves a partnership, corporation or association with another AUD or SLP for reasons of professional misconduct, incompetence or incapacity, a Mandatory Report must be filed setting out the reasons for the dissolution.

AUDs and SLPs should remember that these requirements exist for all regulated health care professionals. This is particularly important for CASLPO members who practice in interdisciplinary settings and become aware of concerns relating to a different regulated health care professional. AUDs and SLPs are not just required to make Mandatory Reports about other AUDs and SLPs.

A Mandatory Report must be made in writing and sent to the Registrar of the College which regulates the health care professional involved. If you don’t have consent from a patient, the report must be made without the patient’s name and personal health information. These reports should generally be made within 30 days of becoming aware of the concerns or events. However, a report must be filed immediately when there are reasonable grounds to believe that the health care professional will continue to sexually abuse the patient or other patients, or that the incompetence or the incapacity of the health care professional is likely to expose a patient to harm or injury and there is urgent need for intervention.

The RHPA gives immunity to people who file Mandatory Reports if the report is made in good faith; that is, not made maliciously. In addition, the duty to make Mandatory Reports overrides other duties of confidentiality.

It is also important to remember that a failure to make a Mandatory Report can carry some serious consequences. Since legislative changes were made to the RHPA (effective May 30, 2017), a regulatory College can seek fines of up to $25,000 against an individual for the first failure to file a report and up to $50,000 for any subsequent failure. These fines are even greater for corporations, where a failure to report can result in a fine of up to $50,000 for the first failed report and up to $200,000 for any subsequent failed reports. It can also constitute professional misconduct to fail to make a Mandatory Report when one is required.

Please note that this article is intended to provide general information about the reporting obligations of AUDs and SLPs. If in doubt about the reporting obligation, AUDs and SLPs should contact the College and/or a Children’s Aid Society for further direction.

Feature Articles

Bob Kroll

President

The Path to the Presidency

In conversation with Bob Kroll, President, CASLPO

By Annette McLeod

Even though it didn’t even exist yet, ever since he graduated with his doctorate in the 1970s, Bob Kroll’s ethics and professional experiences have been pointing him towards a leadership role in an organization like CASLPO.

“I came to Ontario as a motivated, enthusiastic new speech and language pathologist ready to work, with all the 11 years of study I put into it,” he says. “Then I found out that anybody could call themselves a speech language pathologist. It was an unregulated profession. Somebody down the street who took a weekend workshop about kids with issues could call themselves a speech therapist. It was concerning to me, not from a point of view of competition, but why would some of us go through a long, rigorous educational route to become a health professional only to find that anyone could claim they could do the same work? Back then, there was no CASLPO, there was no legislation that regulated our profession.”

Bob says that while the profession did have (and still does have) a professional association, membership was voluntary, and the only requirement was payment of a nominal fee. “There was a group of us that advocated for regulation of the profession as we really thought it would be an opportunity for the public’s interest to be protected as well as a professional responsibility for those that had gained the knowledge and skills through master’s degrees and doctorates", he says. “I’ve had a long-standing interest in making sure that our field is credible in the eyes of patients, raising public awareness, and staunchly advocating for the importance of what we do.”

The evolution of the profession’s regulation, accountability and advocacy has continued in the years since, and Bob says the Regulated Health Professions Act and Audiology and Speech-Language Pathology Act of the early 1990s were exciting developments. “It’s not like when you say you’re a doctor or a dentist,” he notes. “People know what they do. But speech pathology? It was never a very well-known profession. Even today, people ask me what we do, although less frequently.”

The legislation of the professions was real validation, he believes. “To finally be acknowledged by the Ministry of Health and Long-Term Care meant that audiology and speech-language pathology are professions that are important to be regulated, that we are doing important work, and that members should be regulated because there’s a potential risk to the public in what we do.”
Bob has now spent more than 40 years dedicated to those with speech challenges, including the last 20 years at the Speech & Stuttering Institute, where until a couple of months ago he was Executive Director. He recently passed the mantle to a colleague and took up a post as Chair of the Board. Yes, he’s always been a busy man. But, he says, in 2010, his feelings of gratitude towards the profession that has shaped his life prompted him to join the council at CASLPO.

“I thought maybe it was time to give back a little bit,” he says. “I couldn’t give back money, but I could give my time, and maybe a little knowledge and experience, so I threw my hat into the election ring.”

He didn’t hesitate to take on a second term, but when confronted with the possibility of a third three-year term, he says he struggled a bit. In the end, he decided the timing was right. “I’m winding down here at Speech & Stuttering. I talked to my wife and decided it would be a good sort of closure for my career to make a final contribution to CASLPO — both for the college and for the field. So, I decided to let my name stand for President.” At the meeting of Council in June 2017, he assumed that role. “I was very honoured by that,” he says.

After three consecutive terms, members may choose to run again for Council after sitting out a year, but he says this term will be his last. “I believe in passing the torch,” he says. “It doesn’t have to be me making the presentation or giving the lecture. It gives me pleasure to see others stand up and do the stuff I would have done, and maybe better than I would have. I’m not a person who thinks it always has to be me taking the lead and taking the limelight.”

When it comes to filling council seats, he says what’s important is not just “getting bodies in there” but maintaining the standard of excellence. “I can rightly say that I’m proud of how this College has fared compared to others, in terms of our structure, our acting always in the public interest, our public transparency and public awareness and education, and our efficiencies. These are the reasons I feel so honoured to be president.” He says that while he understands his colleagues are stretched thin in terms of their workloads, he emphasizes the importance of the College. “You have to be willing to give something to it or we’re going to go back to where we were in the 70s and 80s,” he says.

He notes that the resources offered by CASLPO are another source of pride. “They’ve done a marvelous job with the website, with the media, and with public awareness,” he says. “I’m always on the website making sure I’m familiar with the bylaws or looking for colleagues by using the public register of members. I have followed the development of the website and enjoyed the learning modules posted there such as the one on obtaining patient consent. It’s a great way to share information.”

He says his goal now is to create an open presidency where everyone feels like they can just pick up the phone — yes, it’s a little old school, but Bob likes it that way. “I’m old fashioned,” he says with a laugh. “You can hear nuance in a person’s voice that you can’t express with your thumbs. I’d like to make people feel comfortable so they can express themselves. You should be able to say, ‘I think that’s rubbish’ and open a dialogue without being upset with each other. I’d like to bring an atmosphere of openness so we can really chew over the issues and give people the respect and acknowledgement they deserve, to use the democratic process to find consensus.”

They may sound like lofty goals, but if Bob’s track record is any indication, it won’t take him long to achieve them.

“I’ve always been interested in doing my bit, to educate the public, government, and employers, about the importance of our work. I’ve always believed we should be meeting standards because we can harm patients if we do the wrong things.”

— Bob Kroll

Bob’s keys to avoiding volunteer burnout:

Be part of a great team

Respect everybody’s opinions

Recognize diversity

Keep learning

Keep up with and use the latest technology

“Over the years, I have tried to get a taste of all facets of the College, so one year I may have been on the Registration Committee, another year on the Inquiries, Complaints and Reports Committee, one year on a Discipline panel as a non-Council member, so the work is constantly changing. The issues confronting the College are constantly changing as well. But what has really kept me going are my Council colleagues — bright, wise, I never tire of listening to their points of view. I’ve been a committee member, chaired a couple of committees, gone from in-person meetings to teleconferencing to video.”

Valuable things Bob Kroll says he has learned through serving on CASLPO Council:

The structure of meetings

Better organization

Strategic planning, not just going from day to day but looking at various long-term opportunities and threats facing an organization

That teams are excellent when you have the right mix of people

How to work as a cohesive unit

How to communicate with government and other officials

How to be effective even when the experience is very challenging, such as serving on a complaints panel.

This website is intended to provide information to the public and members. Should there be differences in documentation previously distributed to CASLPO members, it is up to the member to source the latest version posted on the CASLPO website.